Reconstruction of the nose and external ear in a patient specific manner are some of the greatest challenges in plastic surgery because of the complex, three-dimensional properties of the inner cartilage structure with regionally changing mechanical properties and overlaying skin. Auricular reconstruction is applicable to congenital deformities, microtia, melanoma related tissue sacrifice and injuries including accidents and severe burns. Ears are involved in approximately 90% of burns involving the head and neck. The mostly frequently used standard treatment for total auricular reconstruction in the United States and the European Union is based on a two- to three-stage surgical technique using autologous costal cartilage harvested from the sixth, seventh and eighth rib which is sculpted into an ear-like shape to the extent possible by the limited amount of harvested tissue. Sufficient amount of costal cartilage is generally achieved at age 10, delaying the reconstructive surgery. Another reconstruction method for ear reconstructive surgery is the use of silicone implants to avoid the need for costal cartilage harvesting. However placing an acellular scaffold under a thin layer of skin exposes the patient to a high risk of long-term complications. Additionally, it is impossible to provide for customized size and shape for each patient, and the reconstructed ear does not grow like the contralateral ear leading to asymmetry. Available reconstruction strategies involve several surgeries and their outcome is highly dependent of the expertise of the reconstructive surgeon. Donor side morbidity, collapse of the abdominal wall due to lack of costal cartilage support and severe pain related to the costal cartilage harvest are common complications.
Additionally, there is a large clinical need to repair osteochondral lesions, which occur as a result of sport injury, trauma and degenerative diseases such as osteoarthritis. Current methodologies to treat this involve transplantation of osteochondral grafts, which are either autologous or derived from bone banks. This treatment has several disadvantages including donor site morbidity, scarcity of donor tissue, surgical difficulty and the fact the graft consists of multiple pieces, each which can come loose or be mis-positioned in the height.
In view of this state of the art, the objective of the present invention is to provide methods and means for providing patient specific grafts that improve on the above mentioned deficiencies of the state of the art. This objective is attained by the subject matter of the claims of the present specification.